聚乙二醇干扰素α-2a治疗HBeAg阳性慢性乙型肝炎患者的疗效与影响因素分析  

Study on the curative effect and influence factors of HBeAg positive chronic hepatitis B patients with the treatment of PEG IFN a-2a

作　　者：郑丽青[1] 柴一红[1] 姚履枫[1] 甘巧蓉[1] 张冬青[1] 朱月永[2] 

机构地区：[1]福建省福州市传染病医院,福州350025 [2]福建医科大学附属第一医院肝病中心

出　　处：《福建医药杂志》2016年第6期119-122,共4页Fujian Medical Journal

摘　　要：目的观察聚乙二醇干扰素α-2a(PEG-IFNα-2a)治疗HBeAg阳性慢性乙型肝炎(CHB)的疗效及其影响因素。方法将78例中疗程≥48周的45例纳入研究,治疗结束后随访24周。观察生化学、病毒学及血清学应答,对各指标进行分析。结果治疗24周时HBeAg定量水平≤10s/co的患者可获得较高的HBeAg血清学转换率,较治疗24周时的HBV DNA载量更能准确预测其HBeAg血清学转换率;治疗36周时血清HBsAg水平下降>2lg或绝对值≤10IU/mL的患者可获得较高的HBsAg阴转率,较治疗36周时的HBV DNA载量更能准确预测其HBsAg阴转率。logistic回归分析显示,治疗36周时HBsAg水平及HBsAg水平较基线的下降值是观察结束时HBsAg清除的预测因素。结论治疗24周时的HBeAg定量水平可作为HBeAg血清学转换的预测因素,治疗36周时HBsAg水平及HBsAg水平较基线的下降值是HBsAg清除的预测因素。Objective To evaluate the efficacy of PEG-IFN α-2a in hepatitis B e antigen （HBeAg） -positive chronic hepatitis B （CHB） patients and predicting factor. Methods Seventy-eight HBeAg-positive CHB patients were treated with PEG- IFN α-2a for 48 weeks and off-treatment follow-up 24 weeks and compared the level of ALT, HBV DNA, HBeAg and HBsAg with the method of logistic multiple regression. Forty-five patients with treatment more than 48 weeks were enrolled. Results Serum HBeAg level lower than 10 s/co at 24 weeks was a better predictor for subsequent HBeAg seroconversion than HBV DNA level at 24 weeks. Serum HBsAg decline （〉2 log10 IU/mL） or HBsAg level 10 IU/mL at 36 weeks predict better than HBV DNA level at 36 weeks for subsequent HBsAg loss. Multiple logistic regression analysis and ROC curves indicated that a decline of HBsAg levels from baseline through treatment 36 weeks or HBsAg levels at 36 weeks were important predictors for HBsAg loss at the end of follow-up. Conclusion HBeAg level at 24 weeks may identify those with a greater likelihood of achieving HBeAg seroconversion. HBsAg levels at 36 weeks and a decline of HBsAg levels from baseline to 36 weeks were significantly important predictors for HBsAg loss.

关 键 词：肝炎 慢性 乙型 长效干扰素 疗效 

分 类 号：R512.62[医药卫生—内科学]